| NPI | 1780834457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: NC 8560) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: CO 9130) |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2024-05-06 |